银杏达莫注射液对急性心肌梗死患者冠状动脉再通治疗后QT离散度的影响

摘要

Objective To observe the effect of ginkgo dipyridamole injection on QT dispersion (QTd)in patients with acute myocardial infarction (AMI)after coronary reperfusion therapy.Methods Sixty-eight cases of AMI patients underwent successful thrombolysis or emergency PCI were randomly divided into ginkgo dipyridamole injection intervention group (34 cases)and coronary reperfusion therapy alone group (34 cases).QTd changes of the 2 groups were observed in acute coronary revascularization before treatment,1 day after reperfusion therapy,5days after reperfusion therapy and 10 days after reperfusion therapy.Results QTd in patients with AMI was longer than that in the normal controls [ (76±8 )ms vs (36±5 )ms,P＜0.05 ].QTd was lower in all patients after coronary reperfusion therapy compared with that before therapy (P＜0.05 );the difference was significant.QTd was significantly decreased (P＜0.05 )in ginkgo dipyridamole injection intervention group compared with 5 days after revascularization,1 day after recanalization or 10 days after revascularization.QTd was decreased significantly in ginkgo dipyridamole injection intervention group compared with reperfusion alone treatment group both 5 days after treatment and 10 days after treatment.Conclusion Ginkgo dipyridamole injection can effectively reduce QTd in patients with AMI after coronary recanalization therapy.%目的 观察银杏达莫注射液对急性心肌梗死(AMI)患者冠状动脉再通治疗后QT离散度(QTd)的影响,进一步探讨其临床应用价值.方法 将68例AMI成功接受溶栓或急诊PCI术患者完全随机分为银杏达莫干预组(34例)和常规治疗组(34例),分别在冠状动脉再通治疗前和再通治疗后1、5、10 d做12导联心电图描记,计算QTd.以同期体检健康者68人为正常对照组.结果 AMI患者QTd较正常对照者明显延长[ (76±8) ms比(36±5)ms,P＜0.05].2组患者冠状动脉再通治疗后各时间点QTd较再通治疗前均明显降低[常规治疗组再通治疗后1、5、10 d分别为(56±6)、(58±5)、(46±6)ms比(76±8)ms;银杏达莫干预组分别为(56±7)、(47±5)、(36±4) ms比(77±9 )ms,均P＜0.05].常规治疗组再通治疗后10 d QTd明显低于再通治疗后1、5 d(均P ＜0.05).银杏达莫干预组再通治疗后5dQTd低于再通治疗后1d,再通治疗后10 d低于再通治疗后5d(均P＜0.05).冠状动脉再通治疗后5、10 d,银杏达莫干预组QTd明显低于常规治疗组.结论 银杏达莫注射液可有效降低AMI患者冠状动脉再通治疗后的QTd,有很好的临床应用价值.